Remote Functional Depression of Glucose Metabolism in Stroke and its Alteration by Activating Drugs

Abstract

Applying the [¹⁸F]fluorodeoxyglucose (FDG) method (Reivich et al. 1979a; Phelps 1981) and positron emission tomography (PET) in man, increased local cerebral metabolic rates for glucose (LCMRGl) during functional activation of nervous tissue have been demonstrated for the visual system (Reivich et al. 1979b; Phelps et al. 1981a), for the auditory system (Alavi et al. 1981; Phelps et al. 1982), and for the somatosensory system (Greenberg et al. 1981). By means of the ⁷⁷Kr inhalation technique, an increase in local cerebral blood flow (LCBF) was documented in the motor area after complicated finger movements (Roland et al. 1981). Some of these striking results and prospects on future studies have been reported by Phelps and Mazziotta (this volume) and Reivich et al. (this volume). In other studies of cerebral metabolism in patients suffering from ischemic stroke, a depression of oxygen uptake or glucose metabolism was observed in morphologically intact brain regions: Kuhl et al. (1980) described a reduction of glucose uptake in the thalamus ipsilateral to a cortical infarct. Using FDG (Phelps et al. 1981b) or [¹¹C]3-methyl-Dglucose (Heiss et al. 1982) as metabolic tracer, decreased glucose uptake was found in the CT-intact visual cortex of patients with an infarction in the territory of the middle cerebral artery by which the visual pathway was interrupted.